Driving During Pregnancy Is Not So Black and White

Pregnancy is a time that is full of emotion from elation to downright fear. And it’s really no wonder. It is a life changing event that, unless you’ve been through it before, you can only begin to imagine. And even if you have had children before. Each baby brings new life, new challenges and new personalities to the family.

On top of all that you probably have everyone you see giving you information, advice and tips. It can feel overwhelming and cause some concerns to arise.

During my third pregnancy I was an emotional wreck. I had gone through three miscarriages so was doing everything “by the book” and still worried everyday something would happen. I rented a heart rate doppler when I was far enough along in my pregnancy that I could hear the heartbeat with one. And I checked it. Often.

During all six pregnancies (3 full-term), not once did any of the doctors or midwives bring up the safety concerns of driving during pregnancy. This should be surprising considering the statistics and high potential of negative outcomes to the pregnancy should mom-to-be experience a crash. However, reports suggest only 27% of pregnant women discuss the topic with their doctor.

And the sad fact is, many doctors who may discuss it typically recite what the National Highway Traffic Safety Administration advises. That is, wear the seat belt “positioned low on the abdomen, below the fetus, with the shoulder belt worn normally.” This is well and good but doesn’t incorporate the whole picture.

Many women intuitively have a concern about driving during pregnancy as they buckle up. Some question the safety of the airbag. Some question the safety of the seat belt crossing their abdomen. (Some women simply find it uncomfortable to wear a seat belt during pregnancy, even early on, and consider not wearing it.) And while studies show that wearing a seat belt is three times safer than not wearing one, pregnant women are right to have concerns. Even NHTSA says, “the fetus can be injured by striking the lower rim of the steering wheel or from crash forces concentrated in the area where a seat belt crosses the mother’s abdomen. The seat belt will keep a pregnant woman as far as possible from the steering wheel.”

The seat belt is the first line of defense during a crash. It is meant to cinch down and hold the person into the vehicle seat using the pelvic bones. The seat belt does it’s job well. As NHTSA says in the quote above, the seat belt will keep the woman as far as possible from the steering wheel. That means there is a lot of restraining power that the seat belt uses to cinch a person into their seat, thereby keeping her away from the steering wheel.

The problem arises as the pregnancy develops and comes out in front of the pelvic bones that the seat belt is meant to engage with and cinch down on. At 9 weeks, the pregnancy is still well within the protection of the pelvic bone. But already at 12 weeks, it starts to move out in front of the pelvic bone. These images show a pregnancy in relation to a woman’s body while standing. It looks like there is space “below” the pregnancy. Imagine, if you will, a woman sitting down. The legs rise to be perpendicular to the abdomen and as the pregnancy grows outward, it can literally rest on the legs. Now feel where your pelvic bone is and knowing that the pregnancy is that low inside your pelvic area, how are you supposed to get the seat belt below the pregnancy when the seat belt is supposed to catch those bones?

That’s right. You can’t.

Of course there are many factors in play during a crash especially with a pregnant woman. The speed of the crash is probably the biggest factor. Even in a low-speed minor crash, injuries can occur that affect the pregnancy.

“I didn’t sustain any major injuries and all my minor injuries were caused by the safety features in my car. I had chemical burns on my hands and bruises on both arms where the airbags came out, I also had pain in my chest and face from the airbags. The seatbelt also gave me bruises across my chest and on the bottom of my belly where I was told to wear the belt during pregnancy. Because of the seatbelt the doctors were worried about placental abruption or internal bleeding. I spent the evening in the hospital and the baby was monitored for 13 hours,” mom-to-be, Crickett Holmes, of Durango, Colorado shared about her low-speed crash with a snow plow that unexpectedly started making a U-turn in front of her.

A study by the University of Michigan estimates that about 170,000 car crashes in the U.S. each year involve pregnant women. On average, 2.9% of women report being hurt in a “car accident” during pregnancy. If you do the math based on an average of 4 million babies born a year, that’s 116,000 crashes where a mom-to-be is injured, at least somewhat.

The risk for adverse fetal injuries, such as placental abruption, uterine rupture, direct fetal injury such as a brain injury, maternal death or fetal loss, in a low speed 16 MPH frontal crash at 28 weeks gestation is 26% for belted drivers and 70% for unbelted drivers. A range of studies estimate an average of 3,000 pregnancies are lost every year due to a car crash.

If buckling up is three times safer than not and there is still this high of a number of pregnancies lost, how can we enhance safety for pregnant women while driving?

Here are a few suggestions for safer driving during pregnancy:

Gauge how you feel. If you are feeling fatigued, nauseated or otherwise out of sorts, eat a snack, drink some water or take a rest. Wait to drive until you feel you can have more focus.

Be a passenger. When possible, don’t drive, especially as your pregnancy progresses and your uterus gets closer and closer to the steering wheel.

If you are driving:

Position yourself far back from the steering wheel. Move your seat as far back as is comfortable. Try to position yourself so that your breastbone is at least 10 inches from the steering wheel.

Tilt the steering wheel toward your breastbone rather than toward your abdomen to position the airbag so it does not deploy into the abdomen.

Wear your seat belt.

Use a crash-tested Tummy Shield to safely redirect the seat belt from crossing your abdomen creating a leg harness, much like a race car driver.

Following these suggestions may one day save your baby or the baby of someone dear to you from potentially fatal injuries because of a car crash during pregnancy.

Amie Durocher has been a certified CPS Technician since 2004. She is the Creative Director at Safe Ride 4 Kids, a company that offers up-to-date car safety information and innovative products, like the Tummy Shield to help parents keep their precious little ones safe.